The plastic surgeons are fuming, again, and about to lose, again.

Discussion in 'Dental Archive' started by Dave King, Jun 29, 2004.

  1. Dave King

    Dave King Guest

    Pull a Tooth, Give a Facelift?

    Thursday, June 24, 2004



    Oral surgeons in California will be able to perform plastic surgery,
    if a new bill under consideration in the state Legislature passes.

    This controversial bill, authored by State Sen. John Burton, will give
    dental surgeons the right to do any type of plastic surgery on the
    face -- including nose jobs, face lifts and eye tucks.

    Plastic surgeons are against the bill, saying dentists are only doing
    it for the money, are not qualified for this type of surgery and would
    be putting the patient in danger.

    However, the oral surgeons pointed out they have years of training in
    operating rooms and that they routinely perform plastic surgery in
    emergency rooms. In fact, when a plastic surgeon is unavailable at a
    trauma center, it is dentists who do the facial reconstructions.

    The military also favors letting dentists perform plastic surgery, as
    there are no plastic surgeons out in the field.

    The new bill has already passed the state Senate and is tied up in
    committee, and it is headed next for the full Assembly.
     
    Dave King, Jun 29, 2004
    #1
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  2. Dave King

    W_B Guest

    I hope the bill passes.


    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jun 29, 2004
    #2
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  3. Dave King wrote:
    Hell, at my residency the ER always called the dentist for head/neck
    trauma, maybe because we were American and they could understand us.
    That goes for the GP residents, let alone the OMFS residents. My last
    night on call, I was called for a skull fracture, and I had to draw the
    line!!

    Steve
     
    Steven Bornfeld, Jun 30, 2004
    #3
  4. Dave King

    Dave King Guest

    Precedents have been established in many other states so I think the
    plastics fellas on the west coast should, most likely, just grab a
    kleenex. Boo friggin hoo.


     
    Dave King, Jun 30, 2004
    #4
  5. Dave King

    Dave King Guest

    On Tue, 29 Jun 2004 22:13:03 -0400, Steven Bornfeld
    For the record, Plastic Surgeons do not have a monopoly on facial
    cosmetic surgery, hence its true name.
    This pisses me off. First of all, me and about 12 other surgeons
    (Plastics and OMS) cover facial trauma in the state of Delaware. I
    consider myself very lucky if I get paid 50% of the time. That doesnt
    even consider my lost time in the office and the good old 'reasonable
    and customary'. IT COSTS US MONEY TO TREAT THESE PATIENTS. For
    example, I spent half the day Saturday in the OR then on Sunday, after
    about 7 hours, got called back in at 9:30 PM for a kid that crashed
    his motorcycle into his sisters ATV (he was 10, she 8). Got home at
    2:00 AM, wound down at about 4:00 AM to be back in DE at 8:00AM.
    Fortunately, of the three cases I did on Sunday ( 2 mandibles, 1
    orbital/mandible/nose), I will only get paid for the kid that had a
    mandible fracture. I didnt even mention the 81 yo that was hit by a
    car with a shattered right orbit, nose and maxilla that took 6 hours
    to put back together, 6 plates and 50+ screws and no insurance other
    than medicaid that I finished today.

    The danger part really makes me laugh. If the general public only knew
    what a typical plastic surgeons training consisted of, especially the
    face, these yo-yos would look even more petty. Its not the degree but
    the training, stupid.
    Gotta love the BS here. For an institution to be certified in trauma,
    the law requires OMFS' to be on staff. When I draw the short straw to
    cover facial trauma, its me and the residents. Yep, just the darn
    dentists putting the face back together. What is even funnier, the
    trauma docs (all are either a D.O. or an M.D.) have prefered the darn
    dentists in every institution that I have ever been affiliated with.
    An interesting comment. OMFS in the military are like gold. The
    reason; dual training in facial injuries AND general anesthesia. Talk
    about two birds with one stone. The only shame is in the number of
    dentists that haven't the slightest clue of the training and expertise
    of their own brethren. Not necessarily their fault in most instances
    but that is improving.
    It should pass, like it has in many states, including the one I
    practice in.
    Lovely! Besides speaking english, the little chip on just about every
    OMFS' shoulder means the ER knows who will not only treat the patient
    accordingly but get their butts down their quickly without any BS and
    get the job done. I am just alittle fired up about this since
    cosmetics are a part of my practice that I am working on expanding and
    I just had my second weekend of trauma call in the last month. You
    name it, I treat it.

    Thanks for listening to my rant.

    Dave

    Diplomate, American Board of OMS
    Fellow, American Association of OMS
    Attending, Christiana Care Dept. of OMS
    Attending, AI DuPont Hospital for Children
    Delaware Craniofacial/Cleft Palate Team
    Ass Kicker of any Plastic Surgeon that looks down their nose at me or
    my dental colleagues

     
    Dave King, Jun 30, 2004
    #5
  6. Dave King

    charlie ruff Guest


    In Bangor Maine, the last I looked, the plastic surgeons won't take
    call frosm trauma. They want an 8-5 ish job. So for years the oral
    surgeons have been doing plastic surgery in the event of tramua.
     
    charlie ruff, Jun 30, 2004
    #6
  7. (Dave King) wrote in message news:<>...
    I think this can only benefit dentistry and quality of care for
    patients getting these procedures.

    I've seen too many face lifts where the plastic surgeons stretch
    everything out but forget to address what has happened to the teeth.
    Or these maxillary excess cases that are misdiagnosed as hyperactive
    lips and are treated with Botox vs Orthognathic surgery.





     
    Alexander Vasserman DDS., BS., Jun 30, 2004
    #7
  8. This is a very interesting issue ... especially in my home market.

    We are seeing dentists branch out!


    JOEL

     
    Joel M. Eichen, D.D.S., Jun 30, 2004
    #8
  9. Dave King

    Dave King Guest

    I kinda went off on a tangent here but they often complain about us
    doing cosmetics when the overriding change in reimbursement in trauma
    has lead to OMS picking up the slack. The PS dont want bothered, much
    like what Charlie said in a following post. The surgical aproaches can
    be the same ie: bleph incisions for a ZMC, face lift incision for
    condyles, frontal sinus etc. This is only a natural extension of our
    surgical training. My lack of sleep over the last few days hasn't
    helped so sorry for the tangent taking off.
     
    Dave King, Jun 30, 2004
    #9
  10. Dave King

    W_B Guest

    On Wed, 30 Jun 2004 02:27:41 GMT, (Dave King) wrote:

    Well stated.
    Will invest in Kimberly-Clark stock immediately.


    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jun 30, 2004
    #10
  11. Dave King

    StovePipe Guest

    FWIW: up here, the OS/PS dichotomy is settled on competence. The OS gang
    at l'Hopital de l'Enfant-Jusus built their reputation around solid
    training by one of OS's pioneers (André Charest) and furthered it by
    innovative understudies such as Pierre-Eric Landry (Sliding osteotomy
    the British way ) and others. I've often heard it said that in one of
    the hospital staff happended to get plowed in a car accident, they'd
    rather be put back together by the OS gang than the Plastics boys.

    Further, André Charest recognised early on in designing his program that
    his residents didn't have enough training in trauma, so he started
    shipping them off to Miami (!) for a good three to six months, and then
    to the Inuit communities in the north of Qc and Kanada ( lots of fights
    ).

    The bottom line is competence, period.

    When I was in my multidisciplinary residency at the Mtl General
    Hospital, I saw the differnce between Plastics and OS in my surgery
    rotation: the OS residents were always on rounds, measuring cephs,
    breaking up models to simulate the outcome of segmental osteotomies b/4
    the surgery, or preparing papers to be given after rounds the next day.
    I never saw the Plastics residents seem to be very busy. I firmly
    believe that as a result of this, the OS gang was better trained to
    handle per-operation stress. This is mandatory, as all you OS's that do
    sliding osteotomies know... like when you put in your wire sutures and
    are all set to close.... then you realize your occlusion is way off and
    you have to start again....(!)....

    One more anecdote: the OS gang at the Mtl General were also revered by
    the surgical nurses and support staff for their courtesy and general PR
    abilities. They were often also lauded for the simple but necessary
    ability to remember their instruments by name. One got the impression
    that after being harrassed by the Orthopedics butchers and all the other
    services, the OS gang was like a breath of fresh air.

    Competence, seasoned with a good dose of civility.
    Just my two cents
    B000000oooooooooooooommmmMmmMMM
     
    StovePipe, Jul 1, 2004
    #11
  12. Dave King

    Joseph Guest

    Why on Earth would there need to be laws restricting anyone from doing
    anything to paying patients who know what they are receiving to all
    reasonable extent (contract)? Indeed patients must always have the right to
    sue if a crime has been committed (e.g. using nonsterile equipment
    inappropriately, or nonadherence to the contract), but these "free"
    societies have gotten out of hand.
     
    Joseph, Jul 2, 2004
    #12
  13. In a complex society, patients cannot evaluate technical
    considerations.

    How many people understand the differences (and abilities or lack
    thereof) between an opthomologist, and optometrist, and an oculist?

    How many Jan Drews do not understand the differences between a doctor
    of dentistry and an "alternative-health-care-provider?"


    JOEL
     
    Joel M. Eichen, D.D.S., Jul 2, 2004
    #13
  14. Dave King

    Dave King Guest

    Bingo.

    Good post and the usual comments with regards to hospital training,
    resident initiative, who would you want to fix it etc. These things
    are what are always mentioned to me, even in training, and the reason
    why we are so respected and needed in the care of patients in need of
    our expertise. Its what separates us from the rest of the animals.
    Paying attention to the very little things is what the dental school
    background provides to place us a step ahead.

    Dave
     
    Dave King, Jul 2, 2004
    #14
  15. Dave King

    W_B Guest


    It would appear to be common sense that the OMFS would
    have much more extensive knowledge of head and neck
    anatomy.

    Plastics should stick with skin and silicone.


    --

    W_B

    Take out the G'RBAGE
     
    W_B, Jul 2, 2004
    #15
  16. Dave King

    Dave King Guest

    LOL

    I do know some very good plastic surgeons that concentrate on head and
    neck stuff but when they start to get snotty, POW, right in the
    kisser.
     
    Dave King, Jul 2, 2004
    #16
  17. Problem is we have too many legislators who do not understand the
    difference.

    They still think tongue piercers know the anatomy of the tongue (and
    proper sterilization techniques) better than dentists.






     
    Alexander Vasserman DDS., BS., Jul 2, 2004
    #17
  18. Problem is we have too many legislators who do not know the difference
    between Alt health care providers and doctors.

    They still think tongue piercers in tattoo parlors know the anatomy of
    the tongue and proper sterilization techniques than dentists.





     
    Alexander Vasserman DDS., BS., Jul 2, 2004
    #18
  19. On 2 Jul 2004 13:32:53 -0700, (Alexander
    Vasserman DDS., BS.) wrote:
     
    Joel M. Eichen, D.D.S., Jul 3, 2004
    #19
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